Local Resection Compared With Radical Resection in the Treatment of T1N0M0 Rectal Adenocarcinoma: A Systematic Review and Meta-analysis
BACKGROUND:Local resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection. OBJECTIVE:The aim of this study was to compare local with radical resection in terms of oncologic control (survival and local recurrence), postoperative complications, a...
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Published in | Diseases of the colon & rectum Vol. 58; no. 1; pp. 122 - 140 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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The American Society of Colon and Rectal Surgeons
01.01.2015
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Abstract | BACKGROUND:Local resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection.
OBJECTIVE:The aim of this study was to compare local with radical resection in terms of oncologic control (survival and local recurrence), postoperative complications, and the need for a permanent stoma in adult patients with T1N0M0 rectal adenocarcinoma.
DATA SOURCES:Data were retrieved from Medline, Embase, Central, www.clinicaltrials.gov, and conference proceedings.
STUDY SELECTION:Two reviewers independently screened studies and assessed the risk of bias.
INTERVENTIONS:Local resection (transanal procedures, excluding endoscopic polypectomy) versus radical resection were considered.
MAIN OUTCOME MEASURES:The primary outcomes measured were overall survival, major postoperative complications, and the 'need for permanent stoma.'
RESULTS:One randomized controlled trial and 12 observational studies contributed 2855 patients for analysis. The randomized controlled trial was inadequately powered. Observational study meta-analysis showed that local resection was associated with significantly lower 5-year overall survival (72 more deaths per 1000 patients; 95%CI 30–120). However, the transanal endoscopic microsurgery subgroup did not yield significantly lower overall survival than radical resection. Local resection was associated with higher local recurrence but with lower perioperative mortality (relative risk 0.31, 95% CI 0.14–0.71), major postoperative complications (relative risk 0.20, 95% CI 0.10–0.41), and need for a permanent stoma (relative risk 0.17, 95% CI 0.09–0.30). Findings were robust to sensitivity analyses. Meta-regression suggests that the higher overall survival associated with radical resection may be explained by increased use of local resection on tumors in the lower third of the rectum, which have poorer prognosis.
LIMITATIONS:This systematic review of nonrandomized studies had inherent biases that may persist despite our rigorous use of systematic review methodology and sensitivity analyses.
CONCLUSIONS:Local resection does not offer oncologic control comparable to radical surgery. However, this finding may be driven by the higher prevalence of cancers with poorer prognosis in local resection groups. Local resection is associated with lower postoperative complications, mortality, and the need for a permanent stoma. Local resection with transanal endoscopic microsurgery appears to offer oncologic control similar to that of radical resection while offering all the benefits of local resection. |
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AbstractList | BACKGROUND:Local resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection.
OBJECTIVE:The aim of this study was to compare local with radical resection in terms of oncologic control (survival and local recurrence), postoperative complications, and the need for a permanent stoma in adult patients with T1N0M0 rectal adenocarcinoma.
DATA SOURCES:Data were retrieved from Medline, Embase, Central, www.clinicaltrials.gov, and conference proceedings.
STUDY SELECTION:Two reviewers independently screened studies and assessed the risk of bias.
INTERVENTIONS:Local resection (transanal procedures, excluding endoscopic polypectomy) versus radical resection were considered.
MAIN OUTCOME MEASURES:The primary outcomes measured were overall survival, major postoperative complications, and the 'need for permanent stoma.'
RESULTS:One randomized controlled trial and 12 observational studies contributed 2855 patients for analysis. The randomized controlled trial was inadequately powered. Observational study meta-analysis showed that local resection was associated with significantly lower 5-year overall survival (72 more deaths per 1000 patients; 95%CI 30–120). However, the transanal endoscopic microsurgery subgroup did not yield significantly lower overall survival than radical resection. Local resection was associated with higher local recurrence but with lower perioperative mortality (relative risk 0.31, 95% CI 0.14–0.71), major postoperative complications (relative risk 0.20, 95% CI 0.10–0.41), and need for a permanent stoma (relative risk 0.17, 95% CI 0.09–0.30). Findings were robust to sensitivity analyses. Meta-regression suggests that the higher overall survival associated with radical resection may be explained by increased use of local resection on tumors in the lower third of the rectum, which have poorer prognosis.
LIMITATIONS:This systematic review of nonrandomized studies had inherent biases that may persist despite our rigorous use of systematic review methodology and sensitivity analyses.
CONCLUSIONS:Local resection does not offer oncologic control comparable to radical surgery. However, this finding may be driven by the higher prevalence of cancers with poorer prognosis in local resection groups. Local resection is associated with lower postoperative complications, mortality, and the need for a permanent stoma. Local resection with transanal endoscopic microsurgery appears to offer oncologic control similar to that of radical resection while offering all the benefits of local resection. Local resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection. The aim of this study was to compare local with radical resection in terms of oncologic control (survival and local recurrence), postoperative complications, and the need for a permanent stoma in adult patients with T1N0M0 rectal adenocarcinoma. Data were retrieved from Medline, Embase, Central, www.clinicaltrials.gov, and conference proceedings. Two reviewers independently screened studies and assessed the risk of bias. Local resection (transanal procedures, excluding endoscopic polypectomy) versus radical resection were considered. The primary outcomes measured were overall survival, major postoperative complications, and the 'need for permanent stoma.' : One randomized controlled trial and 12 observational studies contributed 2855 patients for analysis. The randomized controlled trial was inadequately powered. Observational study meta-analysis showed that local resection was associated with significantly lower 5-year overall survival (72 more deaths per 1000 patients; 95%CI 30-120). However, the transanal endoscopic microsurgery subgroup did not yield significantly lower overall survival than radical resection. Local resection was associated with higher local recurrence but with lower perioperative mortality (relative risk 0.31, 95% CI 0.14-0.71), major postoperative complications (relative risk 0.20, 95% CI 0.10-0.41), and need for a permanent stoma (relative risk 0.17, 95% CI 0.09-0.30). Findings were robust to sensitivity analyses. Meta-regression suggests that the higher overall survival associated with radical resection may be explained by increased use of local resection on tumors in the lower third of the rectum, which have poorer prognosis. This systematic review of nonrandomized studies had inherent biases that may persist despite our rigorous use of systematic review methodology and sensitivity analyses. Local resection does not offer oncologic control comparable to radical surgery. However, this finding may be driven by the higher prevalence of cancers with poorer prognosis in local resection groups. Local resection is associated with lower postoperative complications, mortality, and the need for a permanent stoma. Local resection with transanal endoscopic microsurgery appears to offer oncologic control similar to that of radical resection while offering all the benefits of local resection. BACKGROUNDLocal resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection.OBJECTIVEThe aim of this study was to compare local with radical resection in terms of oncologic control (survival and local recurrence), postoperative complications, and the need for a permanent stoma in adult patients with T1N0M0 rectal adenocarcinoma.DATA SOURCESData were retrieved from Medline, Embase, Central, www.clinicaltrials.gov, and conference proceedings.STUDY SELECTIONTwo reviewers independently screened studies and assessed the risk of bias.INTERVENTIONSLocal resection (transanal procedures, excluding endoscopic polypectomy) versus radical resection were considered.MAIN OUTCOME MEASURESThe primary outcomes measured were overall survival, major postoperative complications, and the 'need for permanent stoma.'RESULTS: One randomized controlled trial and 12 observational studies contributed 2855 patients for analysis. The randomized controlled trial was inadequately powered. Observational study meta-analysis showed that local resection was associated with significantly lower 5-year overall survival (72 more deaths per 1000 patients; 95%CI 30-120). However, the transanal endoscopic microsurgery subgroup did not yield significantly lower overall survival than radical resection. Local resection was associated with higher local recurrence but with lower perioperative mortality (relative risk 0.31, 95% CI 0.14-0.71), major postoperative complications (relative risk 0.20, 95% CI 0.10-0.41), and need for a permanent stoma (relative risk 0.17, 95% CI 0.09-0.30). Findings were robust to sensitivity analyses. Meta-regression suggests that the higher overall survival associated with radical resection may be explained by increased use of local resection on tumors in the lower third of the rectum, which have poorer prognosis.LIMITATIONSThis systematic review of nonrandomized studies had inherent biases that may persist despite our rigorous use of systematic review methodology and sensitivity analyses.CONCLUSIONSLocal resection does not offer oncologic control comparable to radical surgery. However, this finding may be driven by the higher prevalence of cancers with poorer prognosis in local resection groups. Local resection is associated with lower postoperative complications, mortality, and the need for a permanent stoma. Local resection with transanal endoscopic microsurgery appears to offer oncologic control similar to that of radical resection while offering all the benefits of local resection. |
Author | Kanters, Steve Colquhoun, Patrick H Ott, Michael C Kidane, Biniam Chadi, Sami A |
AuthorAffiliation | 1 Department of Surgery, Western University, London, Ontario, Canada 2 School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada |
AuthorAffiliation_xml | – name: 1 Department of Surgery, Western University, London, Ontario, Canada 2 School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada |
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References | 25739710 - Chirurg. 2015 Mar;86(3):289 Tierney (R13-18-20210119) 2007; 8 Winde (R25-18-20210119) 1996; 39 Kauer (R28-18-20210119) 2004; 18 De Graaf (R17-18-20210119) 2009; 35 Chakravarti (R8-18-20210119) 1999; 230 Nascimbeni (R21-18-20210119) 2004; 47 Havenga (R3-18-20210119) 1996; 182 Nash (R16-18-20210119) 2009; 52 You (R26-18-20210119) 2007; 245 Sgourakis (R10-18-20210119) 2011; 77 Heintz (R19-18-20210119) 1998; 12 Parmar (R12-18-20210119) 1998; 17 Doornebosch (R9-18-20210119) 2009; 48 Tarantino (R24-18-20210119) 2008; 95 Pakkastie (R2-18-20210119) 1997; 163 Zerz (R7-18-20210119) 2006; 49 Chambers (R11-18-20210119) 2012; 21 Endreseth (R18-18-20210119) 2005; 48 Sun (R30-18-20210119) 2010; 340 Masui (R4-18-20210119) 1996; 39 Lee (R27-18-20210119) 2003; 17 Ptok (R23-18-20210119) 2007; 142 Massari (R29-18-20210119) 1998; 8 Nascimbeni (R5-18-20210119) 2002; 45 Ambacher (R15-18-20210119) 1999; 70 Bhangu (R31-18-20210119) 2013; 258 |
References_xml | – volume: 230 start-page: 49 year: 1999 ident: R8-18-20210119 article-title: Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation. publication-title: Ann Surg doi: 10.1097/00000658-199907000-00008 contributor: fullname: Chakravarti – volume: 39 start-page: 969 year: 1996 ident: R25-18-20210119 article-title: Surgical cure for early rectal carcinomas (T1): transanal endoscopic microsurgery vs. anterior resection. publication-title: Dis Colon Rectum doi: 10.1007/BF02054683 contributor: fullname: Winde – volume: 77 start-page: 761 year: 2011 ident: R10-18-20210119 article-title: Transanal endoscopic microsurgery for T1 and T2 rectal cancers: a meta-analysis and meta-regression analysis of outcomes. publication-title: Am Surg doi: 10.1177/000313481107700635 contributor: fullname: Sgourakis – volume: 21 start-page: 1551 year: 2012 ident: R11-18-20210119 article-title: A five-year prospective study of quality of life after colorectal cancer. publication-title: Qual Life Res doi: 10.1007/s11136-011-0067-5 contributor: fullname: Chambers – volume: 39 start-page: 1140 year: 1996 ident: R4-18-20210119 article-title: Male sexual function after autonomic nerve-preserving operation for rectal cancer. publication-title: Dis Colon Rectum doi: 10.1007/BF02081416 contributor: fullname: Masui – volume: 12 start-page: 1145 year: 1998 ident: R19-18-20210119 article-title: Comparison of results after transanal endoscopic microsurgery and radical resection for T1 carcinoma of the rectum. publication-title: Surg Endosc doi: 10.1007/s004649900802 contributor: fullname: Heintz – volume: 47 start-page: 1773 year: 2004 ident: R21-18-20210119 article-title: Long-term survival after local excision for T1 carcinoma of the rectum. publication-title: Dis Colon Rectum doi: 10.1007/s10350-004-0706-9 contributor: fullname: Nascimbeni – volume: 52 start-page: 577 year: 2009 ident: R16-18-20210119 article-title: Long-term survival after transanal excision of T1 rectal cancer. publication-title: Dis Colon Rectum doi: 10.1007/DCR.0b013e3181a0adbd contributor: fullname: Nash – volume: 18 start-page: 1075 year: 2004 ident: R28-18-20210119 article-title: The value of endosonographic rectal carcinoma staging in routine diagnostics: a 10-year analysis. publication-title: Surg Endosc doi: 10.1007/s00464-003-9088-7 contributor: fullname: Kauer – volume: 8 start-page: 16 year: 2007 ident: R13-18-20210119 article-title: Practical methods for incorporating summary time-to-event data into meta-analysis. publication-title: Trials doi: 10.1186/1745-6215-8-16 contributor: fullname: Tierney – volume: 163 start-page: 929 year: 1997 ident: R2-18-20210119 article-title: A randomised study of colostomies in low colorectal anastomoses. publication-title: Eur J Surg contributor: fullname: Pakkastie – volume: 70 start-page: 1469 year: 1999 ident: R15-18-20210119 article-title: Tumor recurrence after transanal excision of stage I rectal cancer in comparison with radical resection. publication-title: Chirurg doi: 10.1007/s001040050088 contributor: fullname: Ambacher – volume: 95 start-page: 375 year: 2008 ident: R24-18-20210119 article-title: Local excision and endoscopic posterior mesorectal resection versus low anterior resection in T1 rectal cancer. publication-title: Br J Surg doi: 10.1002/bjs.6133 contributor: fullname: Tarantino – volume: 340 start-page: c117 year: 2010 ident: R30-18-20210119 article-title: Is a subgroup effect believable Updating criteria to evaluate the credibility of subgroup analyses. publication-title: BMJ doi: 10.1136/bmj.c117 contributor: fullname: Sun – volume: 49 start-page: 919 year: 2006 ident: R7-18-20210119 article-title: Endoscopic posterior mesorectal resection after transanal local excision of T1 carcinomas of the lower third of the rectum. publication-title: Dis Colon Rectum doi: 10.1007/s10350-005-0305-4 contributor: fullname: Zerz – volume: 8 start-page: 438 year: 1998 ident: R29-18-20210119 article-title: Value and limits of endorectal ultrasonography for preoperative staging of rectal carcinoma. publication-title: Surg Laparosc Endosc doi: 10.1097/00019509-199812000-00008 contributor: fullname: Massari – volume: 17 start-page: 2815 year: 1998 ident: R12-18-20210119 article-title: Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. publication-title: Stat Med doi: 10.1002/(SICI)1097-0258(19981230)17:24<2815::AID-SIM110>3.0.CO;2-8 contributor: fullname: Parmar – volume: 35 start-page: 1280 year: 2009 ident: R17-18-20210119 article-title: Transanal endoscopic microsurgery versus total mesorectal excision of T1 rectal adenocarcinomas with curative intention. publication-title: Eur J Surg Oncol doi: 10.1016/j.ejso.2009.05.001 contributor: fullname: De Graaf – volume: 258 start-page: 563 year: 2013 ident: R31-18-20210119 article-title: Survival outcome of local excision versus radical resection of colon or rectal carcinoma. publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182a4e85a contributor: fullname: Bhangu – volume: 48 start-page: 343 year: 2009 ident: R9-18-20210119 article-title: Is the increasing role of Transanal Endoscopic Microsurgery in curation for T1 rectal cancer justified A systematic review. publication-title: Acta Oncol doi: 10.1080/02841860802342408 contributor: fullname: Doornebosch – volume: 182 start-page: 495 year: 1996 ident: R3-18-20210119 article-title: Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum. publication-title: J Am Coll Surg contributor: fullname: Havenga – volume: 45 start-page: 200 year: 2002 ident: R5-18-20210119 article-title: Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. publication-title: Dis Colon Rectum doi: 10.1007/s10350-004-6147-7 contributor: fullname: Nascimbeni – volume: 142 start-page: 649 year: 2007 ident: R23-18-20210119 article-title: Oncological outcome of local vs radical resection of low-risk pT1 rectal cancer. publication-title: Arch Surg doi: 10.1001/archsurg.142.7.649 contributor: fullname: Ptok – volume: 48 start-page: 1380 year: 2005 ident: R18-18-20210119 article-title: Transanal excision vs. major surgery for T1 rectal cancer. publication-title: Dis Colon Rectum doi: 10.1007/s10350-005-0044-6 contributor: fullname: Endreseth – volume: 245 start-page: 726 year: 2007 ident: R26-18-20210119 article-title: Is the increasing rate of local excision for stage I rectal cancer in the United States justified: a nationwide cohort study from the National Cancer Database. publication-title: Ann Surg doi: 10.1097/01.sla.0000252590.95116.4f contributor: fullname: You – volume: 17 start-page: 1283 year: 2003 ident: R27-18-20210119 article-title: Transanal endoscopic microsurgery and radical surgery for T1 and T2 rectal cancer. publication-title: Surg Endosc doi: 10.1007/s00464-002-8814-x contributor: fullname: Lee |
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Snippet | BACKGROUND:Local resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection.
OBJECTIVE:The aim of this... Local resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection. The aim of this study was to compare... BACKGROUNDLocal resection for early rectal cancer is thought to be less invasive but oncologically inferior to radical resection.OBJECTIVEThe aim of this study... |
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SubjectTerms | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Digestive System Surgical Procedures - mortality Humans Neoplasm Staging Postoperative Complications Proctoscopy Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - surgery Survival Rate |
Title | Local Resection Compared With Radical Resection in the Treatment of T1N0M0 Rectal Adenocarcinoma: A Systematic Review and Meta-analysis |
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